Irrigation vs. natural evacuation of left colostomy

Abstract

A comparative study of 2 methods of managing left colostomy (irrigation and natural evacuation) was carried out on 340 patients who were examined and interviewed at the Stoma Rehabilitation Clinic of the Institute of Surgical Pathology of the University of Padua [Italy]. Of patients who irrigated their colostomies, 92% gained fecal continence. No patient who irrigated his colostomy had any cutaneous problem, and this group had significantly better results in preventing leakage of gas and odors compared with those patients using natural evacuation. For most patients who irrigated, the ability to predict or control bowel movements overcame fears of being dirty and related psychological problems. These patients also had more normal social and working lives than did those patients not irrigating their colostomies. Only 1 patient in our series had a colonic perforation. Any chance of a repeat incident will probably disappear with the cone-shaped catheters now available. In properly selected patients, irrigation is the method of choice for management of left colostomy.